Eight-week, multimodal exercise counteracts a progress of chemotherapy-induced peripheral neuropathy and improves balance and strength in metastasized colorectal cancer patients: a randomized controlled trial

Zimmer, Philipp; Trebing, Sina; Timmers-Trebing, Ursula; Schenk, Alexander; Paust, Rainer; Bloch, Wilhelm; Rudolph, R.; Streckmann, Fiona; Baumann, Freerk T.

doi:10.1007/s00520-017-3875-5

Cited by 150 publications

(192 citation statements)

References 40 publications

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“…Our patients performed more than two third of the prescribed exercise sessions. Considering the high variety of our patient group with different diagnosis and disease severities, we assume a reasonable coherence rate that lies in the range of other interventional studies with cancer patients in general (69) or CIPN patients specifically (41). Conclusively, we maintain that up-weighting proprioception and thereby down-weighting vestibular information towards the behavior of healthy subjects represents a clear benefit for CIPN patients.…”

Section: Effects Of the Interventionmentioning

confidence: 82%

“…Concerning treatment, knowledge about the management of CIPN-induced postural instability is still sparse (39)(40)(41). Generally, it is increasingly suggested to focus on strength and especially balance exercises in order to improve physical functioning of CIPN patients (11), what we could confirm in a randomized controlled trial by ourselves (42).Until recently, there are only two other interventional studies showing that balance exercises improved CIPN-related postural control deficits (39,41).…”

mentioning

confidence: 99%

“…Furthermore, since CIPN treatment options are very limited so far (3) and hints in the recent literature indicate that CIPN patients might benefit from exercising(39,41,58), we evaluated a balance-based…”

mentioning

confidence: 99%

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A new approach to characterize postural deficits in chemotherapy-induced peripheral neuropathy and to analyze postural adaptions after an exercise intervention

Kneis

Wehrle

Dalin

et al. 2019

Preprint

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Background Postural instability presents a common and disabling consequence of chemotherapy-induced peripheral neuropathy (CIPN). However, knowledge about postural behavior of CIPN patients is sparse. With this pilot study, we used a new approach to i) characterize postural impairments as compared to healthy subjects, ii) allocate possible abnormalities to a set of parameters describing sensorimotor function, and iii) evaluate the effects of a balance-based exercise intervention. Methods We analyzed spontaneous and externally perturbed postural control in eight CIPN patients before and after a balance-based exercise intervention by using a modification of an established postural control model. These findings were compared to 15 matched healthy subjects. Results Spontaneous sway amplitude and velocity were larger in CIPN patients compared to healthy subjects. CIPN patients’ reactions to external perturbations were smaller compared to healthy subjects, indicating that patients favor vestibular over proprioceptive sensory information. The balance-based exercise intervention up-weighted proprioceptive information in patients. Conclusions CIPN patients’ major postural deficit may relate to underuse of proprioceptive information that results in a less accurate posture control as spontaneous sway results indicate. The balance-based exercise intervention is able to partially correct for this abnormality. Our study contributes to a better understanding of postural impairments in CIPN patients and suggests an effective treatment strategy.

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Section: Effects Of the Interventionmentioning

confidence: 82%

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confidence: 99%

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A new approach to characterize postural deficits in chemotherapy-induced peripheral neuropathy and to analyze postural adaptions after an exercise intervention

Kneis

Wehrle

Dalin

et al. 2019

Preprint

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“…Det er nylig gjennomført to randomiserte, kontrollerte studier som viste positiv effekt av fysisk trening på både symptomer og fysisk funksjon (17)(18).…”

Section: «Det Er Viktig At Pasienten Får Et Hjemmetreningsprogram»unclassified

“…Tiltak som transcutan nervestimulering (TENS) og akupunktur er kjent for å ha effekt på nevropatiske smerter, men det er få studier ved CIPP (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19).…”

Section: «Det Er Viktig At Pasienten Får Et Hjemmetreningsprogram»unclassified

Lindring av polynevropati etter cellegift

Haugen¹,

Haugen²

2018

Sykepleien

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En vanlig seneffekt etter kreftbehandling er cytostatikaindusert perifer polynevropati (CIPP). Denne artikkelen redegjør for en tverrfaglig tilnaerming til lindring av CIPP.Cytostatikaindusert perifer polynevropati (CIPP) kan vaere en plagsom seneffekt etter kreftbehandling. Sykepleieren har en viktig rolle når det gjelder å kartlegge symptomer og iverksette tiltak. Sykepleieren kan også ta initiativ til samarbeid med annet helsepersonell der pasienten kan ha nytte av et tverrfaglig tilbud.Cytostatikabehandling mot kreftsykdom involverer bruk av en rekke saerlig toksiske legemidler (1). Cytostatika retter seg for det meste mot å hemme DNA-replikasjonen i definerte faser der tumorceller er mer sårbare enn friske celler. FAGUTVIKLING Lindring av polynevropati etter cellegift CIPP Polynevropati Kreftbehandling Seneffekter Kreft

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Effect of Exercise on Chemotherapy-Induced Peripheral Neuropathy Among Patients Treated for Ovarian Cancer

Cao

Cartmel

et al. 2023

JAMA Netw Open

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ImportanceChemotherapy-induced peripheral neuropathy (CIPN), one of the most common and severe adverse effects of chemotherapy, is associated with worse quality of life among survivors of ovarian cancer. Currently, there is no effective treatment for CIPN.ObjectiveTo evaluate the effect of a 6-month aerobic exercise intervention vs attention-control on CIPN among women treated for ovarian cancer in the Women’s Activity and Lifestyle Study in Connecticut (WALC) to provide evidence to inform the guidelines and recommendations for prevention or treatment of CIPN.Design, Setting, and ParticipantsThis prespecified secondary analysis evaluated the Women’s Activity and Lifestyle Study in Connecticut (WALC), a multicentered, open-label, population-based, phase 3 randomized clinical trial of an aerobic exercise intervention vs attention control for CIPN in patients who were diagnosed with ovarian cancer. Only WALC participants who received chemotherapy were included in this analysis. Participants were randomized 1:1 to either a 6-month aerobic exercise intervention or to attention control. All analyses were conducted between September 2022 and January 2023.InterventionsThe exercise intervention consisted of home-based moderate-intensity aerobic exercise facilitated by weekly telephone counseling from an American College of Sports Medicine/American Cancer Society–certified cancer exercise trainer. Attention control involved weekly health education telephone calls from a WALC staff member.Main Outcomes and MeasureChange in CIPN was the primary outcome in this secondary analysis. This outcome was represented by CIPN severity, which was self-measured by participants at baseline and 6 months using the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group–Neurotoxicity scale, with a score range of 0 to 44. A mixed-effects model was used to assess the 6-month change in CIPN between the exercise intervention and attention control arms.ResultsOf the 134 participants (all females; mean [SD] age, 57.5 [8.3] years) included in the analysis, 69 were in the exercise intervention arm and 65 were in the attention control arm. The mean (SD) time since diagnosis was 1.7 (1.0) years. The mean (SD) baseline CIPN scores were 8.1 (5.6) in the exercise intervention arm and 8.8 (7.9) in the attention control arm (P = .56). At 6 months, the self-reported CIPN score was reduced by 1.3 (95% CI, −2.3 to −0.2) points in the exercise intervention arm compared with an increase of 0.4 (95% CI, −0.8 to 1.5) points in the attention control arm. The between-group difference was −1.6 (95% CI, −3.1 to −0.2) points. The point estimate was larger among the 127 patients with CIPN symptoms at enrollment (−2.0; 95% CI, −3.6 to −0.5 points).Conclusions and RelevanceFindings of this secondary analysis of the WALC trial indicate that a 6-month aerobic exercise intervention vs attention control significantly improved self-reported CIPN among patients who were treated for ovarian cancer. While replication of the findings in other studies is warranted, incorporating referrals to exercise programs into standard oncology care could reduce CIPN symptoms and increase quality of life in patients with ovarian cancer.Trial RegistrationClinicalTrials.gov Identifier: NCT02107066

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Eight-week, multimodal exercise counteracts a progress of chemotherapy-induced peripheral neuropathy and improves balance and strength in metastasized colorectal cancer patients: a randomized controlled trial

Cited by 150 publications

References 40 publications

A new approach to characterize postural deficits in chemotherapy-induced peripheral neuropathy and to analyze postural adaptions after an exercise intervention

A new approach to characterize postural deficits in chemotherapy-induced peripheral neuropathy and to analyze postural adaptions after an exercise intervention

Lindring av polynevropati etter cellegift

Effect of Exercise on Chemotherapy-Induced Peripheral Neuropathy Among Patients Treated for Ovarian Cancer

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